Cytokine abnormalities in Preeclampsia - a loss of maternal tolerance.
This study involves the assessment of maternal and placental immune status at the time of delivery. Markers of maternal anti-fetal immunity have been identified in the placental bed and placenta at term delivery. The cellular responses of the uterus to the placental invasive cells is being examined. The active role of the placenta in modifying this uterine response is abnormal in preeclampsia with a decrease in the ability to induce a passive maternal response. The timing and relevance of these changes in the early prediction of the disease will be determined.
Non-steroidal antiinflammatory agents and post-partum hypertension.
A randomized clinical trial has recently been approved by Canberra to investigate whether non-steroidal pain killers used after routine caesarean section delivery are implicated in causing high blood pressure after pregnancy. This unit has recently identified a potentially deadly increase in blood pressure in women who already have elevated blood pressure. These events run the risk of damaging the blood vessels and causing longterm damage to the mother. This study will compare an old fashioned non-steroidal treatment with a more modern form of the drug and compare that with placebo. Women will be given adequate pain relief in the form of other medication thought not to be related to increased blood pressure. We are indebted to Welsh Allen for the donation of precious blood pressure monitoring machines and to the Pharmacology Department of the RPA Hospital who have been instrumental in setting up the study. We are also grateful for the guidance of the NHMRC Clinical Trial Centre, at Camperdown for trial design and randomization stratification.
The effects of agents used to treat maternal hypertension are being examined for their effects on placental protein production and immunological function. There are no current studies which have investigated the direct effects of these drugs on placental function. There are some clinical studies which suggest that certain agents are more important in causing growth restriction in the babies than other drugs. We are investigating where these effects are mediated by the placental changes.